Provider Demographics
NPI:1487877882
Name:HERRIN, HERMAN KEITH JR (DDS)
Entity type:Individual
Prefix:
First Name:HERMAN
Middle Name:KEITH
Last Name:HERRIN
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4607 MIMOSA DR
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-5815
Mailing Address - Country:US
Mailing Address - Phone:713-661-6134
Mailing Address - Fax:713-218-0724
Practice Address - Street 1:2518 DORRINGTON ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-1929
Practice Address - Country:US
Practice Address - Phone:713-661-3583
Practice Address - Fax:713-218-0724
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14408122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist